Reimbursement for Fines or Penalties. In the event that CE pays a fine to a state or federal regulatory agency, and/or is assessed civil penalties or damages through private rights of action, based on an impermissible access, use or disclosure of PHI by BA or its subcontractors or agents, then BA shall reimburse CE in the amount of such fine or penalties or damages within thirty (30) calendar days from City’s written notice to BA of such fines, penalties or damages. Attachment 1 – CITY/SFDPH Privacy Attestation, version 06-07-2017 Attachment 2 – CITY/SFDPH Data Security Attestation, version 06-07-2017 BAA ATTACHMENT 1 Contractor Name: Supplier ID CITY/SFDPH PRIVACY ATTESTATION INSTRUCTIONS: Contractors and Partners who receive or have access to health or medical information or electronic health record systems maintained by the City and County of San Francisco (CITY/SFDPH) must complete this form. Retain completed Attestations in your files for a period of 7 years. Be prepared to submit completed attestations, along with evidence related to the following items, if requested to do so by CITY/SFDPH. If you believe that a requirement is Not Applicable to you, see instructions below in Section IV on how to request clarification or obtain an exception.
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Reimbursement for Fines or Penalties. In the event that CE pays a fine to a state or federal regulatory agency, and/or is assessed civil penalties or damages through private rights of action, based on an impermissible access, use or disclosure of PHI by BA or its subcontractors or agents, then BA shall reimburse CE in the amount of such fine or penalties or damages within thirty (30) calendar days from City’s written notice to BA of such fines, penalties or damages. Attachment 1 – CITY/SFDPH Privacy Attestation, version 06-07-2017 Attachment 2 – CITY/SFDPH Data Security Attestation, version 06-07-2017 BAA ATTACHMENT 1 Contractor Name: Supplier ID CITY/SFDPH PRIVACY ATTESTATION INSTRUCTIONS: Contractors and Partners who receive or have access to health or medical information or electronic health record systems maintained by the City and County of San Francisco (CITY/SFDPH) must complete this form. Retain Xxxxxx completed Attestations in your files for a period of 7 years. Be prepared to submit completed attestations, along with evidence related to the following items, if requested to do so by CITY/SFDPH. If you believe that a requirement is Not Applicable to you, see instructions below in Section IV on how to request clarification or obtain an exception.
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Samples: sfgov.org, www.sfgov.org